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Therapy for therapists

23 Oct 19
Sue Smith
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Therapy for therapists

This week I’m touching on an interesting subject – the need for therapy for those working therapeutically with clients.

‘Why would you see a counsellor that needs help themselves’? I hear you shout.

Well there are a few things to unpick here.

Let’s start by re-framing this thought, consider this: –

  1. Who wants to be helped by someone that doesn’t look after their own mental health?
  2. You don’t have to be ill to access counselling
  3. Recognising the need to deal with an emotion or a problem is a strength not a weakness
  4. Clients benefit from therapists who are self-aware – it assures that their counsellor is totally in their perspective and not distracted with their own feelings

Starting to make a it more sense now? I’m going to expand on this and will start by outlining the difference between clinical supervision and personal therapy

Clinical Supervision

Some of you may be aware that counsellors and psychotherapists access clinical supervision with a trained supervisor. This is a requirement for membership of professional bodies such as the British Association of Counselling and Psychotherapy (BACP).

Clinical supervision is a regular meeting with an experienced practitioner trained to supervise other practitioners. My BACP requirements for accreditation purposes are that I receive a minimum of 1.5 hours clinical supervision per month. My clinical supervisor is a Dr, a Chartered Psychologist and I have worked with her for over 8 years now. My previous clinical supervisor was a Certified Trauma Specialist (CTS), and Snr Accredited Counsellor (BACP) and she provided my supervision for over 15 years.

The purpose of supervision:

BACP describes supervision as: ‘A specialised form of professional mentoring provided for practitioners responsible for undertaking challenging work with people. Supervision is provided to ensure standards, enhance quality, advance learning, stimulate creativity, and support the sustainability and resilience of the work being undertaken’ (BACP, 2016)

What this means is that in practise I meet with my supervisor and we work through what is going on for me within my practise.  For example – I may discuss with my supervisor a client scenario that I am struggling with. My supervisor may provide pointers or suggest new ways of working with the client. My supervisor is also aware of ethical considerations and ensures my practise is best practise, she would report anything that concerned her about my ability to work with clients.

Sometimes there may be personal things going on for me or a specific reasons why I am struggling with a particular scenario. That’s normal I’m human. Clinical supervision is a safe space for me to work through those issues to ensure that my work with my clients is the best it possibly can be.

Clinical supervision however is not personal therapy.

The BACP state that supervision is not:

‘the same as therapy. At times, it is appropriate for a supervisor to offer support to a supervisee who is experiencing a personal crisis, but that support should not become lengthy, overshadow client concerns or lessen the process of supervision’.

A clinical supervisor may suggest that their supervisee would benefit from some therapeutic work as part of the clinical supervision consultation. However, in the same way as a counsellor cannot accept a client that they know personally for counselling work, the clinical supervisor cannot provide therapeutic interventions to someone they are contracted to provide clinical supervision to. This ensures professional boundaries are maintained.

So, to simply define the two –

Clinical supervision – is a professional process that ensures my practise is safe and in the best interests of clients.

Personal therapy – is a personal process to explore my personal issues in the same way as I would facilitate the process for a client.

Personal Therapy

Whilst not a professional requirement I would argue that accessing personal therapy when needed is a professional thing for any practising counsellor to do.

At the end of the day I am human the same as anyone else (allegedly)! I have fluctuating levels of mental health and ability, usually influenced by external factors.

Like most people I try to put things to the back of my mind and get on with life. Mostly things come and go, mental resilience prevails, and things are fine.

Sometimes however I know that something is lingering and no matter how much I rationalise it and try to put it to rest it keeps reminding me its there. It could be a particular crisis or problem that’s playing on my mind or a pattern of behaviour I’ve developed. Ultimately if it doesn’t feel healthy to me then chances are its not a healthy thing to ignore and carry through my day to day life.

So, when I need to I will access personal therapy to explore what is going on for me, to help me make sense and put those emotions/feelings/thoughts or behaviours to rest.

Why wouldn’t I? Its healthier for me to be grounded, self-aware and fully functioning. It’s also better for my loved ones as believe me those close to you know when things aren’t great. And finally, but not least, its better for me professionally and that benefits my clients.

Last thought

I hope this has provided a little insight into some of the world of counselling beyond the counselling room.

Last thought:

How hypocritical would it be for me as a counsellor to expect clients to access therapy when they have issues impacting on them if I was not willing to do the same myself?

Yes, I’m a counsellor, yes I’m human and yes I will access counselling when I need to.

Talking Trauma

14 Oct 19
Sue Smith
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TALKING TRAUMA

Post Traumatic Stress Disorder (PTSD) is being spoken about more often nowadays. Its included within scripts for TV dramas, recognised more within the mental health arena and generally acknowledged by society as a real condition.

But what does it mean? And what does it look like?

This blog gives a brief overview of this fascinating area of psychology.

Firstly, its important for me to say that personally I dislike the ‘D’ the disorder bit of PTSD. The symptoms of PTSD are the resulting factor of the brain working as it should when we experience non-normal life events. Such events trigger responses in the acute stage, at the time of the event and those responses are triggered to protect you, to save your life. Indeed, given horrendous, terrifying circumstances I would be more concerned about the survivor who experienced them and stated they were fine with no effect than someone who presented with trauma related symptoms.

However, for some people, and I believe many more than those currently diagnosed, the symptoms do not subside or fade over a period of time. Rather they continue, keeping the event, the incident, the trauma ‘charged’ as if it were still happening. So, your logic tells you it happened in the past, but you feel like it just happened yesterday, indeed the most common symptoms are those of re-experiencing where the individual relives the event through flashbacks, dreams, intrusive thoughts and imagery. In this respect when symptoms persist and interfere with day to day life for a prolonged period then I guess its fair to refer to it as disordered. Though I prefer to consider the circumstance as the trauma is still charged.

Many sufferers suffer in silence, thinking they’re ‘mad’ or ‘bad’ and wishing they could return to be the person they were before the event. To those around them they may appear to be out of character, have mood swings, or lack interest in previously enjoyed activities.  Its difficult for friends and loved ones to comprehend because the traumatic event is not charged for them, it is a memory, consigned to the memory banks. This can amplify the negative beliefs of the person experiencing symptoms and silence them further.

Image if you will: ‘The grandma who was mugged on her way back from bingo, she was pushed to the ground and her handbag snatched. That was over two years ago, but she still does not go to bingo and she still repeats the story over and over. Family response initially was good but now she often gets reminded that it was years ago and its been to court and she needs to put it behind her.’      Sounds familiar? She could have PTSD.

To be diagnosed with PTSD a certain number of symptoms must be present from three categories. The categories are: Re-experiencing, Avoidance and Arousal.

Individuals can also suffer with some symptoms, say for example from just one category, thereby not meeting the threshold for diagnosed PTSD, and still find themselves struggling to cope. This is because the symptoms can keep the traumatic incident charged even when there are not enough for full PTSD. The most draining of the symptoms are usually the re-experiencing ones.

Avoidance symptoms are; as the name suggests, methods of avoiding the re-experiencing symptoms being triggered. So people avoid talking about what happened, avoid watching their favourite soap opera because of the current story line, avoid the news, throw themselves into distraction by doing a task or turn to substances as a way of blocking it out.
The ultimate avoidance for some sadly is suicide.

Imagine this then:

Your gut, your feelings, your emotions are screaming at you ‘ this is difficult this is painful you need to deal with it’ while your head is shouting back ‘yes this is difficult this is painful, I’m not going to think about it’.

This conflict is a continuing battle of Re-experiencing VS Avoidance and the outcome is Arousal.

Arousal symptoms include: Sleep disturbance, irritability, hyper vigilance, lack of concentration to name a few.

The cycle continues: You have put the trauma in the suitcase and place the closed suitcase on the shelf behind you. You’re aware of it but you’re leaving it there as you want to get on with life. But every now and again something reminds you that the suitcase is there. Not only are you reminded of the suitcase, but something opens it and shows you the content within. You are back there, reliving not just the memories but the associated feelings and emotions that went with it. You desperately want that case closed and back on its shelf. So, you use whatever avoidance technique is at your disposal and regain control. Until the next time….

As a therapist with a passion for trauma I am in awe of the courage needed by traumatised people. Not only in surviving the extremely draining symptoms and continuing to find ways to function, but also in the strength it takes to access therapy. Think about this vicious circle, the trauma needs to be worked on to take the charge from it, the last thing you want to do is to re-experience the trauma, so naturally you’re going to avoid therapy if you can. Therapy is the act of doing exactly what your head is trying to stop you doing!

It stands to reason for all clients, particular those with traumatic memories that a safe environment along with a working pace timed to suit the individual is paramount to building a healthy therapeutic relationship.

Further information about symptoms and treatment is available at:

https://www.nice.org.uk/guidance/ng116 

More trauma talk in future blogs.

World Mental Health Day 10th October.

10 Oct 19
Sue Smith

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Today, October 10th is World Mental Health Day.

World Mental Health Day.

Its important to remember that Mental Health like Physical Health it fluctuates, some days are great some not so good. In winter arthritics feel their pain more, under pressure and at times of stress someones good mental health may deteriorate.
So how is your mental health on World Mental Health Day?
If its good – great! Keep looking after yourself and appreciate it may change.

If its not so good – be aware, spot the signs of deterioration, be kind to yourself. Seek some help if necessary.
And on World Mental Health Day always remember that we do not know what is going on for other people today, tomorrow, next week. If someone seems different don’t be shy – ask this simple question -‘How are you today?’

Welcome to the Specialist Support Solutions new website.

07 Oct 19
Sue Smith
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Hi,

Welcome to the Specialist Support Solutions new website.  Please have a look around, and visit us regularly to keep up with new announcements, training offerings and blog posts as we continue to develop the site over the coming months.

Thanks.

Sue Smith.